Winterproofing your baby

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If your baby's toes and belly are cold after a trip outside, they are under-dressed

Choose water- and wind-resistant materials for snowsuits or jackets

When winter hits, some parents bundle up their kids as if they were attempting a Mount Everest climb, while others let their children out wearing just a heavy sweater and gloves. What's the best way to dress a child against the cold?

Kids 5 and younger need more insulation than their parents since they lose heat more rapidly than adults. One big reason: There's less body mass to cool on a child and proportionally more skin, through which heat is lost. Also, kids can't generate body heat for as long as adults because their smaller muscles can store only so much heat-generating glycogen, said Mark Widome, a professor of pediatrics at the Pennsylvania State University College of Medicine.

The mercury doesn't have to dip below freezing for the cold to harm your child. Depending on how long your child is outdoors, wind and dampness can also accelerate frost nip (temporary damage to exposed skin), frostbite (severe tissue damage, most often to hands and feet) and hypothermia (lowered body temperature, which in some cases can be life threatening). One thing to look forward to: Children's resistance to cold improves as they grow.

Here is, by age, how much and what type of clothing kids need.

Birth to 6 weeks: When the temperature or windchill dips below freezing or when nonfreezing temperatures are mixed with wind or rain, it's best to keep newborns inside except for brief excursions (for example, to and from the car).

"They're just getting used to the outside world after living in a temperature-regulated, 98.6-degree bath," Widome said.

If you do take a newborn out in the cold, use several inner layers, such as a cotton snap-bottom undershirt and a fleece sleeper. Then button your baby up in a polyester or down-filled bunting, and wrap him in a blanket. Placing him in a front carrier inside your coat can help block wind and cold, but make sure his mouth and nose aren't obstructed. Once back indoors, be sure to remove layers promptly so that the baby doesn't become overheated; a newborn isn't any better at cooling himself down.

Indoors, the more comfortably babies are dressed for bed, the better they sleep. If you swaddle your baby, use a lightweight cloth. Cotton's the best bet for sleeping because it's cozy, soft and more breathable than other fabrics.

Skip the blankets in the crib until around 12 months -- they're a suffocation risk before then, and babies just kick them off. Instead, try a coverall, a one-piece outfit with feet -- also called a sleeper or a stretchie -- or a sleep sack, which is a wearable blanket with armholes. A fitted flannel crib sheet adds warmth, too.

If your baby sleeps in your bed, she'll get extra heat from you, so she can be dressed lighter. A swaddling cloth may be all she needs. (Keep in mind that your pillows, sheets and blankets are a suffocation risk and should be kept away from her.)

Six weeks to a year: Older babies typically need one layer more than their parents, especially if they're lying inactive in a stroller. Hooded infant snowsuits (without drawstrings, which are a strangulation hazard) of polyester or down are ideal. Always put the hood up (use a fleece hat if the snowsuit has no hood) to cover a baby's head and ears. Uncovered, body heat escapes rapidly from the head.

To tell if your baby is dressed warmly enough, feel her toes and belly as soon as you come indoors. The toes should feel slightly cool, though not chilly, and the belly warm. If the stomach is also cool, the baby is struggling to warm herself. If the belly and the toes are equally warm, she could be overdressed.

One to 4 years: A damp down snowsuit or cotton jacket pulls heat away from the body, so once your child starts playing outdoors, choose water- and wind-resistant material. Outerwear doesn't have to be bulky to be warm. Thin materials, such as Quallofil or Thinsulate, protect against cold. The overall fit of the suit or jacket, including closures at wrists and ankles, should be snug (the neck should be high but comfortable) to keep out wind and snow; bibs on overalls should come up high on the chest and back.

High-performance underwear is even more essential than a premium snowsuit. Avoid cotton, which will dampen with perspiration after your child starts running around. Try polyester-rayon blends or silk, which wick moisture away from the skin.

Always make sure to protect the head, hands and feet. Good bets: a wool or polyester fleece hat, water- and wind-resistant gloves or mittens and waterproof and insulated boots. Toddlers are notoriously bad at judging when their hands or feet are cold because they become so absorbed in whatever they're doing. "They'll even get frostbite without complaint," Widome warns. Watch for bright-pink skin with white spots, the early signs of trouble.

Don't bother with scarves. They can catch on something and wrap too tightly around the neck. Fleece neck gaiters are a safer bet.

Lastly, fill 'em up with a hearty meal and plenty to drink before they go out, Widome suggests. The fluids will help their bodies fight the cold more effectively, and they'll come in sooner because they will need to urinate.

Skincare

Babies are prone to heat rash and eczema flareups in the winter. Blame all those layers of clothes, or the dry, warm air circulating in your house. Keep an eye out for the following:

• Heat rash looks like tiny red pimples and usually appears on moist, overheated areas, such as behind the ears, in the neck folds, in the groin or any other spots where warm clothing creates friction.• Eczema is dry skin that looks like flaky, red patches. It's most common in the winter and often shows up -- just in time for holiday pictures -- on a baby's face.

If either of these conditions appears, dressing your baby in lightweight, loose-fitting cotton clothing and avoiding over-bundling should help.

You might also want to try a humidifier. Look for one that automatically kills bacteria, like the Vicks PureMist UV Light Tower or the Honeywell QuietCare Advanced UV Tower, so you don't have to sanitize the unit every day. Keeping your baby's fingernails trimmed is also a good idea, as scratching already irritated skin can lead to secondary infections. And talk to your doctor to find out if your baby needs a topical medication.

You can also try these skin soothers:

• For heat rash: Mix one teaspoon baking soda in a cup of cool water, and blot the area with a fluffy washcloth or cotton ball.• For eczema: After a bath, blot the area gently with a towel, leaving the patches damp. Then apply a lotion, which will seal in the moisture and help hydrate your baby's skin.